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3 comics created by military veterans that help us understand war.

Cartoonists and veterans are working together to heal the wounds of war, and it's beautiful.

3 comics created by military veterans that help us understand war.

The tiny town of White River Junction, Vermont, is home to two big institutions: the White River Junction VA Medical Center and the Center for Cartoon Studies.

Historically, the veterans and cartoonists haven’t had much to do with each other. But a few years ago, James Sturm, the director of the Center for Cartoon Studies (CCS), decided that they should start.

So he brought his paper and pencils to the rec room at the VA and asked the veterans to tell him their stories.


Sturm is part of a larger movement called graphic medicine, the idea that comics have a universal language of signs and symbols that can help patients more effectively communicate their stories.

He believes sharing stories can both heal patients and create a better health care system.

During his time at the VA, Sturm discovered that comics are a powerful medium for working with post-traumatic stress disorder, in particular.

“PTSD is the inability to integrate past and present, which has a devastating effect on the future,” Sturm said. But comics help people literally visualize time, so they can help veterans break down complex histories into manageable chunks.

“Each panel is a discrete unit of time,” he elaborates. “And when you put 8, 9, 10 panels on a page, you’re integrating the past, present, and future into a ... whole.”

Last fall, Sturm gathered a group of cartooning students and veterans and encouraged them to collaborate on a volume of oral histories.

“When I Returned” is the resulting book, and it visually demonstrates the disorienting experience of PTSD, as well as the ways the past and the present collide in every moment.

All images via James Sturm, used with permission.

In the opening story, cartoonist Jeff Lok shows us in six simple panels how PTSD works:

While driving in his car, Vince moves back and forth between New England and Iraq, the past and present compressing together. We travel with him from a dusty New Hampshire road to a morgue in Iraq.

Although cartoonist and veteran Mike Rodriguez hasn’t been diagnosed with PTSD, he also lives with the daily reminders of his time in Iraq.

His story is in the book, too:

“I’ll always remember when I got ambushed for like three hours,” he said. ”I was stuck in this position where I had to play dead. ... You don’t ever forget that. It’s part of you.”

In his comic, which he drew himself, images of Fallujah are the constant backdrop to his everyday life in New Hampshire. They linger in the background as he socializes, works as a librarian, and draws at his drafting table.

Every panel communicates the disorientation of moving from a military to a civilian life.

The heart of the book is “Kevin’s Story,” a deeply intimate account of a man’s sexual assault and recovery.

Kevin’s trauma occurred off the battlefield, after he returned from Germany to small-town New Hampshire. On New Year’s Eve 1981, he was raped by a group of strangers in a snowy field. He went home, burned his clothes, and kept his story a secret for the next three decades.

“I come from an old-school family in northern New Hampshire,” he explained. “And we’re the kind where you suck it up and deal with it, and I did it for 32 years.” But then his secret started literally making him sick.

For these men, comics were a powerful part of their healing processes.

Kevin's therapist was using a technique called prolonged exposure therapy, in which he tells his story over and over again to become desensitized to it. And even though he’d told it to her dozens of times, until he sat down with comic students J.D. Lunt and Kelly Swann, he’d never told anybody else.

“I was watching them and looking at their eyes and wondering how they were going to tell [my] story,” he remembered. “I get really worried about what people are going to think and what they’re going to say. But the feedback and response has been unreal. Nobody looks down on me, nobody thinks any different about me, people are saying how proud they are that I shared my story.”

It’s a profound relief for him that his story is out there and he can’t go back into hiding. “It gets lighter and easier all the time,” he says.

Chaplain and cartoonist Kurt F. Shaffert is volunteering at the White River Junction VA and practicing what he calls process cartooning, a system he developed during his eight years working at the Connecticut VA.

During his 15-minute visits with patients, he uses stick figures to help them access what's on their mind quickly and effectively. He finds that when he asks veterans to narrate stick figures, they can “express the inexpressible.”

Comics, Shaffert believes, are the language we need when we talk about war experiences because they’re physical and visual and funny and tragic and profound all at the same time.

“Extraordinary experiences require extraordinary language,” he said.

“Anybody who’s experienced PTSD has experienced things that are outside of everyday experience. ... In order to be able to process events that are traumatic, you need to find ... a form of communication that deals with the immature, the impolite, the gross, the grotesque, the obnoxious, the obscene."

Although researchers haven’t yet studied the effectiveness of comics for treating PTSD, it’s similar to other methods like art therapy and narrative therapy, which are already being used successfully with veterans.

Clinicians and staff members at the White River Junction VA are enthusiastic about this project and excited about future collaborations and the healing potential of cartooning. They hope other VA centers will start using comics for good, too.

Image via Kurt Shaffert.

Maybe starting to heal can be as simple as drawing a stick figure in a hospital room on an ordinary white piece of paper.

This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

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This article originally appeared on August 27, 2015

Oh, society! We have such a complicated relationship with relationships.

It starts early, with the movies we are plopped in front of as toddlers.

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Each year, an estimated 1.8 million people in the United States are affected by cancer — most commonly cancers of the breast, lung, prostate, and blood cancers such as leukemia. While not everyone overcomes the disease, thanks to science, more people are surviving — and for longer — than ever before in history.

We asked three people whose lives have been impacted by cancer to share their stories – how their lives were changed by the disease, and how they're using that experience to change the future of cancer treatments with the hope that ultimately, in the fight against cancer, science will win. Here's what they had to say.

Celine Ryan, 55, engineer database programmer and mother of five from Detroit, MI

Photo courtesy of Celine Ryan

In September 2013, Celine Ryan woke up from a colonoscopy to some traumatic news. Her gastroenterologist showed her a picture of the cancerous mass they found during the procedure.

Ryan and her husband, Patrick, had scheduled a colonoscopy after discovering some unusual bleeding, so the suspicion she could have cancer was already there. Neither of them, however, were quite prepared for the results to be positive -- or for the treatment to begin so soon. Just two days after learning the news, Ryan had surgery to remove the tumor, part of her bladder, and 17 cancerous lymph nodes. Chemotherapy and radiation soon followed.

Ryan's treatment was rigorous – but in December 2014, she got the devastating news that the cancer, once confined to her colon, had spread to her lungs. Her prognosis, they said, was likely terminal.

But rather than give up hope, Ryan sought support from online research, fellow cancer patients and survivors, and her medical team. When she brought up immunotherapy to her oncologist, he quickly agreed it was the best course of action. Ryan's cancer, like a majority of colon and pancreatic cancers, had been caused by a defect on the gene KRAS, which can result in a very aggressive cancer that is virtually "undruggable." According to the medical literature, the relatively smooth protein structure of the KRAS gene meant that designing inhibitors to bind to surface grooves and treat the cancer has been historically difficult. Through her support systems, Ryan discovered an experimental immunotherapy trial at the National Institutes of Health (NIH) in Bethesda, MD., and called them immediately to see if she was eligible. After months of trying to determine whether she was a suitable candidate for the experimental treatment, Ryan was finally accepted.

The treatment, known as tumor-infiltrating lymphocyte therapy, or TIL, is a testament to how far modern science has evolved. With this therapy, doctors remove a tumor and harvest special immune cells that are found naturally in the tumor. Doctors then grow the cells in a lab over the next several weeks with a protein that promotes rapid TIL growth – and once the cells number into the billions, they are infused back into the patient's body to fight the cancer. On April 1, 2015, Ryan had her tumor removed at the NIH. Two months later, she went inpatient for four weeks to have the team "wash out" her immune system with chemotherapy and infuse the cells – all 148 billion of them – back into her body.

Six weeks after the infusion, Ryan and Patrick went back for a follow-up appointment – and the news they got was stunning: Not only had no new tumors developed, but the six existing tumors in her lungs had shrunk significantly. Less than a year after her cell infusion, in April 2016, the doctors told Ryan news that would have been impossible just a decade earlier: Thanks to the cell infusion, Ryan was now considered NED – no evaluable disease. Her body was cancer-free.

Ryan is still NED today and continuing annual follow-up appointments at the NIH, experiencing things she never dreamed she'd be able to live to see, such as her children's high school and college graduations. She's also donating her blood and cells to the NIH to help them research other potential cancer treatments. "It was an honor to do so," Ryan said of her experience. "I'm just thrilled, and I hope my experience can help a lot more people."

Patrice Lee, PhD, VP of Pharmacology, Toxicology and Exploratory Development at Pfizer

Photo courtesy of Patrice Lee

Patrice Lee got into scientific research in an unconventional way – through the late ocean explorer Jacques Cousteau.

Lee never met Cousteau but her dreams of working with him one day led her to pursue a career in science. Initially, Lee completed an undergraduate degree in marine biology; eventually, her interests changed and she decided to get a dual doctoral degree in physiology and toxicology at Duke University. She now works at Pfizer's R&D site in Boulder, CO (formerly Array BioPharma), leading a group of scientists who determine the safety and efficacy of new oncology drugs.

"Scientists focused on drug discovery and development in the pharmaceutical industry are deeply committed to inventing new therapies to meet unmet needs," Lee says, describing her field of work. "We're driven to achieve new medicines and vaccines as quickly as possible without sacrificing safety."

Among the drugs Lee has helped develop during her career, including cancer therapies, she says around a dozen are currently in development, while nine have received FDA approval — an incredible accomplishment as many scientists spend their careers without seeing their drug make it to market. Lee's team is particularly interested in therapies for brain metastases — something that Lee says is a largely unmet need in cancer research, and something her team is working on from a variety of angles. "Now that we've had rapid success with mRNA vaccine technology, we hope to explore what the future holds when applying this technology to cancers," Lee says.

But while evaluating potential cancer therapies is a professional passion of Lee's, it's also a mission that's deeply personal. "I'm also a breast cancer survivor," she says. "So I've been on the other side of things and have participated in a clinical trial."

However, seeing how melanoma therapies that she helped develop have affected other real-life cancer patients, she says, has been a highlight of her career. "We had one therapy that was approved for patients with BRAF-mutant metastatic melanoma," Lee recalls. "Our team in Boulder was graced by a visit from a patient that had benefited from these drugs that we developed. It was a very special moment for the entire team."

None of these therapies would be available, Lee says without rigorous science behind it: "Facts come from good science. Facts will drive the development of new drugs, and that's what will help patients."

Chiuying "Cynthia" Kuk (they/them) MS, 34, third-year medical student at Michigan State University College of Human Medicine

Photo courtesy of Cynthia Kuk

Cynthia Kuk was just 10 years old when they had a conversation that would change their life forever.

"My mother, who worked as a translator for the government at the time, had been diagnosed with breast cancer, and after her chemotherapy treatments she would get really sick," Kuk, who uses they/them pronouns, recalls. "When I asked my dad why mom was puking so much, he said it was because of the medicine she was taking that would help her get better."

Kuk's response was immediate: "That's so stupid! Why would a medicine make you feel worse instead of better? When I'm older, I want to create medicine that won't make people sick like that."

Nine years later, Kuk traveled from their native Hong Kong to the United States to do exactly that. Kuk enrolled in a small, liberal arts college for their Bachelor's degree, and then four years later started a PhD program in cancer research. Although Kuk's mother was in remission from her cancer at the time, Kuk's goal was the same as it had been as a 10-year-old watching her suffer through chemotherapy: to design a better cancer treatment, and change the landscape of cancer research forever.

Since then, Kuk's mission has changed slightly.

"My mom's cancer relapsed in 2008, and she ended up passing away about five years after that," Kuk says. "After my mom died, I started having this sense of urgency. Cancer research is such that you work for twenty years, and at the end of it you might have a fancy medication that could help people, but I wanted to help people now." With their mother still at the forefront of their mind, Kuk decided to quit their PhD program and enter medical school.

Now, Kuk plans to pursue a career in emergency medicine – not only because they are drawn to the excitement of the emergency room, but because the ER is a place where the most marginalized people tend to seek care.

"I have a special interest in the LGBTQ+ population, as I identify as queer and nonbinary," says Kuk. "A lot of people in this community and other marginalized communities access care through the ER and also tend to avoid medical care since there is a history of mistreatment and judgement from healthcare workers. How you carry yourself as a doctor, your compassion, that can make a huge difference in someone's care."

In addition to making a difference in the lives of LGBTQ+ patients, Kuk wants to make a difference in the lives of patients with cancer as well, like their mother had.

"We've diagnosed patients in the Emergency Department with cancer before," Kuk says. "I can't make cancer good news but how you deliver bad news and the compassion you show could make a world of difference to that patient and their family."

During their training, Kuk advocates for patients by delivering compassionate and inclusive care, whether they happen to have cancer or not. In addition to emphasizing their patient's pronouns and chosen names, they ask for inclusive social and sexual histories as well as using gender neutral language. In doing this, they hope to make medicine as a whole more accessible for people who have been historically pushed aside.

"I'm just one person, and I can't force everyone to respect you, if you're marginalized," Kuk says. "But I do want to push for a culture where people appreciate others who are different from them."